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Artificial Organ and Transplantation Surgery

The Department of Artificial Organs and Transplantation specializes in living and cadaveric donor liver transplantation for patients with end-stage liver disease, for which careful management and a team approach involving various clinical departments are required.

Medical services

A team of specialists in liver transplantation provide medical services both in the outpatient clinic and inpatient wards. There are also coordinators from the Organ Transplantation Services to support donors in dealing with their problems and address other issues specific to organ transplant. The physician attending the patient during hospitalization will generally be responsible for postoperative outpatient treatment.

Diagnosis and treatment policy

Our motto is “to perform highly advanced, safe, and successful liver transplants.” With this motto, the department staff carefully discusses and reviews each case daily to achieve the best outcomes in Japan.

Specialties

Living donor partial liver transplant

The Transplantation Surgery Department of the University of Tokyo Hospital performed the first living donor liver transplant in Japan on January 31, 1996. As of July 2016, the number of patients undergoing living donor liver transplant at this hospital reached 556, including 478 adults and 78 children. This is the second largest number of liver transplants in Japan. The survival rate for liver transplant at this hospital is higher than the national average by about 10%. The 1-, 3-, and 5-year posttransplant survival rates are 93%, 86% and 84%, respectively (as of July 2016).

  • There have been 343 cases of liver transplants from brain-dead donors in Japan. Our Hospital, designated as a hospital for liver transplants from braindead donors, has successfully performed 24 liver transplants from braindead donors.
  • Auxiliary Partial Orthotopic Liver Transplantation (APOLT) is also Performed.

Indications for liver transplantation

Biliary atresia, metabolic liver disease, Wilson’s disease, citrullinemia, familial amyloid neuropathy, fulminant hepatitis, viral (type B and C) decompensated cirrhosis, primary biliary cirrhosis, primary sclerosing cholangitis, chronic cholestasis, primary hepatocellular carcinoma (insurance coverage is within the Milan criteria only, less than 5cm in diameter and less than 5 in number is our indication for liver transplantation (Tokyo criteria)), etc.

Advanced treatments/ Specialized treatments

  • Designated institution for liver transplants from brain-dead donors and living donors
  • Surgical treatment using cryopreserved vein grafts
  • Navigation system for hepatectomy using 3-dimensional images

Frequently performed tests

Outpatients
  • Autologous blood storage (donor)
  • CT
  • Abdominal ultrasound examination
  • Upper gastrointestinal endoscopy (including ligation of esophageal varices)
  • ICG test
  • HLA, lymphocyte Cross-match test
Inpatients
  • Liver biopsy
  • ERCP
  • Abdominal ultrasound examination
  • Angiography
  • CT
Norihiro Kokudo

Norihiro Kokudo

Departments/Divisions

Hepatobiliary and Pancreatic Surgery, Organ Transplantation Service, Department of Chemotherapy

Titles

M.D. , Ph.D.

Expertise/Specialties

Hepato-Pancreato Biliary Surgery, Hepatocellular Carcinoma, Liver Cancer, Living Donor Liver Transplant

Research Interests

Surgical treatment of hepatocellular carcinoma, colorectal liver metastases, pancreatic cancer, bile duct cancer, and gallbladder cancer. Safe liver resection. Intraoperative ultrasound. Liver transplantation.

Languages

Japanese / English

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Numbers of major operations and treatments performed

Name of operation/treatment Number
1 Adult-to-adult living donor partial liver transplantation 15
2 Brain-dead donor liver transplantation 1

(2015)

Areas of expertise, treatment and examination methods

Diseases
  1. Biliary atresia
  2. Metabolic liver diseases
  3. Viral cirrhosis B and C
  4. Primary biliary cirrhosis
  5. Primary sclerosing cholangitis
  6. Primary hepatocellular cancer
  7. Fulminant hepatitis
  8. Alcoholic cirrhosis, and others
Treatment methods
  1. Adult-to-adult living donor partial liver transplantation (including auxiliary partial orthotopic liver transplantation)
  2. Brain-dead donor liver transplantation

Numbers of major and specialized examinations conducted in this department

Name of examination Number
1 Color Doppler abdominal ultrasound 478
2 Abdominal CT and 3-D image analysis (image-based navigation for hepatectomy) 41
3 Donor preoperative liver biopsy 6

(2015)

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